目的 探讨经腋静脉行双隧道式外周静脉穿刺中心静脉置管(peripherally inserted central catheters,PICC)在血液肿瘤患者中的应用效果。方法 采用便利抽样法选取2024年1-10月在某院血液科行PICC置管的血液肿瘤患者为研究对象,将1-5月收治的80例患者作为对照组,经贵要、肱静脉行非隧道式PICC置管;6-10月收治的78例患者作为试验组,经腋静脉行双隧道PICC置管,比较两组患者的导管相关并发症、置管操作质量、置管后24 h穿刺点渗血发生率及置管后2周内导管维护次数。结果 试验组患者的导管脱出、导管相关性血栓、导管相关血流感染(catheter related bloodstream infection, CRBSI)的发生率、置管后24 h穿刺点渗血及2周内导管维护次数等方面均低于对照组(均P<0.05)。结论 经腋静脉行双隧道PICC置管有利于减少导管相关并发症的发生,具有一定的临床操作性,可在临床推广使用。

Objective To investigate the application effect of double-tunnel peripherally inserted central catheters (PICC) via the axillary vein in patients with hematologic malignancies.Methods Convenience sampling was used to select patients with hematologic malignancies who underwent PICC catheterization in the hematology department of a hospital from January to October 2024.A total of 80 patients admitted from January to May were included in the control group and received non-tunnel PICC catheterization via the basilic or brachial vein.A total of 78 patients admitted from June to October were included in the experimental group and received double-tunnel PICC catheterization via the axillary vein.Catheter-related complications,catheterization operation quality,incidence of puncture site bleeding at 24 hours after catheterization,and number of catheter maintenance sessions within 2 weeks after catheterization were evaluated and compared between the groups.Results The incidence of catheter dislodgement,catheter-related thrombosis,catheter-related bloodstream infection (CRBSI),puncture site bleeding at 24 hours after catheterization,and number of catheter maintenance sessions within 2 weeks in the experimental group were all lower than those in the control group (all P<0.05).Conclusions Double-tunnel PICC catheterization via the axillary vein is beneficial for reducing the occurrence of catheter-related complications with good clinical operability,and can be promoted for clinical use.

R473.73

浙江省医药卫生科技计划项目(2025KY978)